|

AGENCY

RECORD NUMBER
RECORDS SERIES
AGENCY FILE NUMBER

ORIGINATOR
FROM

TO

TITLE

DATE

PAGES
SUBJECTS

DOCUMENT TYPE
CLASSIFICATION
RESTRICTIONS
CURRENT STATUS

DATE OF LAST REVIEW
OPENING CRITERIA
COMMENTS

NW 88613 Docid:34528544 Page 1

Date
Page : 1

JFK ASSASSINATION SYSTEM
‘IDENTIFICATION FORM

AGENCY INFORMATION

INSCOM/CSF

194-10004-10135

DOD-AFFILIATED -PERSONNEL INCIDENT INVESTIGATIONS
PAGES 14-14A

DOCUMENT INFORMATION

USA
USAPSG

DCS-OPS USAINTC

[ RESTRICTED ]
05/05/67

2

FROMER, DAVID REED

REQUEST FOR AND RESULTS OF PERSONNEL SECURITY ACTION

PAPER, TEXTUAL DOCUMENT
CONFIDENTIAL

3

RELEASED WITH DELETIONS
03/07/95

RECORD REGRADED UNCLASSIFIED ON 2°SEP 94.

01/13/98

Slessed_ onder the John - Kenned Asssssnchor Mecods= Collschom Act o

arenes

1A Ebi Wit TCU ok ee eRe a rE RRM! 8 20

REQUEST FOR AND RESULTS OF PERSONNEL SECURITY ACTION | 5 May 1967

AR 381-130,

FROM: (Requesting Agen cy)

TO: (Control Office)
DCS+OPS
USAINTC
ATIN: OPS III (Mr. Burwasser)
| Fort Holabird, Md.

i (Enter name and address of the ACTION AGENCY fo which results are to be sent, if known by
requester) :

USAPSG

CONTROL OFFICE USE [CONTROL OFFICE USE ONLY |
REQUIREMENT REQUEST NO.

U.5s Army Fevsonnel Security Group
‘Fort Holabird, Maryland 21219 ©
ATTN: “ Adjudications Division

OPENING DATE

_

SECTION | — REQUESTER TO CONTROL OFFICE

(1. SUBJECT (Last name oo) pueterteet and 2. ALIAS(ES), MAIDEN NAME 3. SERVICE/SOCIAL SECURITY NO,
@ names. .

FROMER, David Reed None _ §64+58«8137

#4. DATE OF BIRTH 5. PLACE OF BIRTH (City,. State and country) 6 GRADE AND POSITION
} (Day, Month, Year) :

21 July 1942 Chicago, Illinois Registrant
7. REQUESTED ACTION CAINVESTIGATION [_]VALIDATION [_]RECORDS CHECK
[8. TYPE OF INVESTIGATION: 9, 2.FOR CLEARANCE AND/OR ACCESS TO:

Cynac [jnact (jet (JOTHER(Explain in Item 15) ([\top secret ([_]secrer ([] CONFIDENTIAL
10. TO DETERMINE SUITABILITY FOR:

b. ["] FOR LIMITED ACCESS AUTHORIZATION

«. ° [_JINTERIM CLEARANCE DESIRED
d. (J OTHER (Explain in Item 15)

P11. JUSTIFICATION

p12. REVIEW OF FILES REQUIRED BY PARAGRAPH ___ AR 604-5, COMPLETED ON REVEALED:
([] No UNFAVORABLE INFORMATION Tounravoraste INFORMATION DETERMINED NOT TO SE A BAR TO ACTION
CONTEMPLATED :
f [] INFORMATION SUMMARIZED IN ITEM 18 . -
ft3. LATEST INVESTIGATION/ CLEARANCE (Type, when, by whom) . ‘ 14. NO BREAK IN FEDERAL SERVICE

EXCEEDING SIX MONTHS SINCE

ts. REMARKS (if unfavorable information catored, iranemit in sealed envelope thru intelligence channels.).

) Request that Headquarters ¢ and Local FBI (S) file checks be conducted on SUBJECT's
| parents.
"Request this investigation be ‘oxpedited as determination under AR 604-10 is

being delayed at | Department of the Arny pending results", : - .

HEGRAL So tiny
ON? CTIFIED
BY CL , + FOUPO

“AUTH Pea vscs BO £200.1R

ot. LH

“Dossier $64588137| 3B PIRNEGAN 14 stonature
re SUBJECT COL AIS

SECTION Il - CONTROL OFFICE TO REQUESTER
‘168. (7 NEW FINGERPRINT CARD REQUIRED . . 4

(C] tTems ON SPH (PSQ) REQUIRE CORRECTION AND/OR COMPLETION.
([J INTERIM REPORT FORWARDED.. REQUEST REPORT OF ACTION TAKEN AND RETURN OF INCLOSURES UPON (COMPLETION.

TYPED NAME AND TITLE

DA . "2784

NW 88613 Docld:34528544 Page 2


17. REPORT OF ACTION ry
noon o

CO INFoORMATION NOTED MATION CONSIDERED NO BAR.TO

] SUBJECT REASSIGNED TONON-. =. [J INFOR
SENSITIVE DUTIES, INVESTIGATION CLEARANCE. REQUEST COMPLETION

_MAY BE CANCELED. OF INVESTIGATION,

SUBJECT WAS TRANSFERRED

HEADQUARTERS

REMARKS (If returning corrected forms, state here)

TYPED NAME AND TITLE SIGNATURE

SECTION IV —- CONTROL OFFICE TO ACTION AGENCY
RESULTS OF PERSONNEL SECURITY ACTION

i) NO RECORD “(7 FAvoraBLe

20.

(CL) MINOR’ UNFAVORABLE INFORMATION RECORDED IN ITEM 21

(FJ PRIOR INVESTIGATION INSUFFICIENT FOR ACTION CONTEMPLATED (CD) FORWARDED FOR SECURITY DETER-
tr NEEDED, INITIATE REQUEST FOR NVESTIGATION.|

MINATION BY CLEARING AUTHORITY
TYPE OF INVESTIGATION

_ [COMPLETED BY
(Nac ()Nac1 Cs ([] OTHER

21. REMARKS

DOSSIER NUMBER

a4, THIS FORM, TOGETHER WITH ANY INCLOSURES, REPORT OF ACTION TAKEN AND USACRF COPY OF DA FORM 873

(if appropriate) WiLL. BE RETURNED TO THE CONTROL OFFICE WITHIN DAYS AFTER RECEIPT.

IN THE EVENT SUBJECT HAS BEEN TRANSFERRED FROM YOUR COMMAND, THIS FORM AND INCLOSURES WILL BE
RETURNED IMMEDIATELY WITH ITEM 23 COMPLETED.
ATTENTION IS INVITED TO: PARAGRAPHS

AR 604-5; PARAGRAPH___AR 604=11; PARAGRAPH
AR 640-98; AND PARAGRAPH AR 381~130, AS APPLICABLE. ,

TYPED NAME AND TITLE SIGNATURE

SECTION V - ACTION AGENCY TO CONTROL OFFICE

REPORT OF ACTION

(CT) FAVORABLE DETERMINATION, USACRF (T] UNFAVORABLE DETERMINATION,

RECOMMENDED ACTION IN ITEM 24

(CL) REQUEST ADDITIONAL INVESTI-
COPY DA FORM 873 ATTACHED

, GATION AS INDICATED IN ITEM 24
23. SUBJECT WAS TRANSFERRED

TO HEADQUARTERS DATED

REMARKS

“TED
| ang | FOUPD
3 Bp 5200.18

TYBED NAME AND- . SIGNATURE .

a

a

NW 88613 Docld:34528544 Page 3

